Tightening the reins on nursing practice
Article first published online: 15 AUG 2013
© 2013 John Wiley & Sons Ltd
Volume 20, Issue 3, page 187, September 2013
How to Cite
Rudge, T. and Thorne, S. (2013), Tightening the reins on nursing practice. Nursing Inquiry, 20: 187. doi: 10.1111/nin.12047
- Issue published online: 15 AUG 2013
- Article first published online: 15 AUG 2013
Nurses from diverse corners of the globe are confronting various jurisdictional manifestations of evolving managerial philosophies within the context of the ever-tightening regulatory framework affecting all health professions (Benton, González-Jurado and Beneit-Montesinos in press; Traynor et al. in press). Although the factors and forces shaping these changes may reflect quite disparate local conditions, there is increasing evidence that the professional advocacy voice many nurses consider fundamental to nursing's capacity to influence public and health policy on behalf of the public they serve is being constrained and constricted by complex organizational and systemic factors (MacDonald et al. 2012).
By virtue of its public safety mandate, obligating it to protect the public against the harms that could result from professional misdeeds and malpractices, the dominant instinct of a nursing regulatory body becomes an imperative to serve the interests of the government from which it takes its authority. This has the effect of orienting its priorities and policies in direct contradistinction to the expressed needs and values of the profession it self-regulates. Similarly, managerial strategies in increasingly efficiency and austerity-oriented model of health service delivery systems typically work to exert as much control as possible over the scope and decisional authority afforded to professional nursing practice. In this manner, nurses find themselves subjugated to regimes of control that wear various masks, including those of ‘rationality, consensus, development, of penetrating compassion, of acting-in-our-own-best-interests, warning us of our fate, robbing us of any basis of criticism and leaving only refusal’ (Traynor 1999, 176).
In this context, the operant ideological forces align in their efforts to reduce the capacity of nurses to think for themselves, assuming a reduction in error rates and risk. Thus, the regulatory and administrative contexts within which nursing education and practice take place are systematically encouraging the profession to stick to narrowly defined roles and functions that are safest and to avoid that which pushes social, legal or conventional boundaries. In essence, the current practice context impedes those very forces that have always allowed for attention to such nurse safety issues as moral distress and the advancement of nursing ideals on behalf of those the profession serves.
With its long history of publishing social critique associated with nursing contexts of practice, Nursing Inquiry has a particular role to play in fostering thoughtful scholarship to expose ideological positionings and to ensure that opposing discourses are not silenced. Our Editorial Board considers this evolving regulatory and managerial climate to be a critically important concern for the thought leaders of the profession at this point in our history. We are therefore sending out a call for submissions for a ‘Special Issue’ of Nursing Inquiry on the topic of Managerialism, Governmentality and the Evolving Regulatory Climate. Although we anticipate that this will be an evolving concern, and will consider manuscripts at any time, we would appreciate submissions by December 31, 2013 so that we can build a strong collection. We have not predetermined the publication date for the special issue; however, accepted manuscripts will be accessible to readers in a timely manner on Early View.
We look forward to receiving your best ideas!
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